Veterinary anesthesia: an opportunity to reduce the environmental footprint of clinical care.

Volatile anesthetic agents are potent greenhouse gases with warming potential hundreds to thousands of times greater than CO2. As health systems, both human and veterinary, seek to reduce their environmental impacts, responsible anesthetic stewardship is a topic of great interest. Through an online survey, we explored the levels of awareness, beliefs, interest, needs, and current actions of veterinary anesthesia professionals around the climate impacts of anesthetic care.

The Edwards Acumen IQ system using peripheral arterial catheter-based waveforms to estimate cardiac output is not accurate as compared to thermodilution in dogs.

Objective: To assess the agreement between cardiac output (CO) estimated via evaluation of the arterial pressure waveform by a novel monitoring system (Edwards Acumen IQ sensor and HemoSphere Advanced Monitor Platform [HS-IQ]; Edwards LifeSciences) and measured by thermodilution (TD) in anesthetized, normovolemic, and hypovolemic dogs. To assess the agreement between the HS-IQ CO measurements in the radial artery and dorsal metatarsal artery.

Animals: 8 purpose-bred Beagles.

The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008-2021.

Recognition of antimicrobial resistance in equine practice has increased over the past decade. The objective of this study was to provide an updated retrospective review of antimicrobial regimens in one tertiary referral hospital and to evaluate the association with postoperative complications. A secondary objective was to evaluate other perioperative factors including surgical procedure, anesthetic and recovery parameters, and the effect of perioperative medications on complications and outcomes.

Review of intra-articular local anaesthetic administration in horses: Clinical indications, cytotoxicity, and outcomes.

Equine practitioners frequently inject local anaesthetics (LA) intra-articularly in both diagnosis of lameness and for pain management intra- or post-operatively with synovial endoscopy. Recent reviews of the human and veterinary literature support the concept that chondrotoxicity of LA on joint tissues depends on the type of drug, dose administered, and duration of exposure. The purpose of this review is to summarise the current literature describing intra-articular local anaesthetic use, including both in vitro and in vivo studies, and to draw some comparisons to literature from other species where potential toxicity and duration of effect have been evaluated with the goal of advancing the field's understanding of intra-articular local anaesthetic use in horses, and indicating future directions for the field.

Current Antimicrobial Use in Horses Undergoing Exploratory Celiotomy: A Survey of Board-Certified Equine Specialists.

In the past decade, there has been a considerable increase in the recognition of antimicrobial resistance in equine practice. The objective of this study was to survey the current clinical use of antimicrobials for a commonly performed surgical procedure (exploratory celiotomy) with the goal of understanding how recent literature and changes in microbial resistance patterns may have impacted antimicrobial selection practices. An electronic survey was distributed to veterinary professionals within the American College of Veterinary Internal Medicine (ACVIM) and the American College of Veterinary Surgery (ACVS).

Distinct differences in immunological properties of equine orthobiologics revealed by functional and transcriptomic analysis using an activated macrophage readout system.

Introduction: Multiple biological therapies for orthopedic injuries are marketed to veterinarians, despite a lack of rigorous comparative biological activity data to guide informed decisions in selecting a most effective compound. Therefore, the goal of this study was to use relevant bioassay systems to directly compare the anti-inflammatory and immunomodulatory activity of three commonly used orthobiological therapies (OTs): mesenchymal stromal cells (MSC), autologous conditioned serum (ACS), and platelet rich plasma (PRP).

Methods: Equine monocyte-derived macrophages were used as the readout system to compare therapies, including cytokine production and transcriptomic responses.

Waste not want not: piloting a clinical waste audit at a United States university veterinary teaching hospital.

Biomedical waste is a well-recognized environmental problem, yet less is known about the waste generated in the delivery of veterinary care compared to human medicine. The objective of this project was to develop and pilot a waste audit protocol for veterinary medicine that could inform waste management at a US university veterinary teaching hospital and the broader veterinary community. We conducted a multi-day review of the Colorado State University Veterinary Teaching Hospital's small animal surgery and anesthesia units to measure the types and amounts of waste generated during routine surgeries.

Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares.

Background: Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species.

Objectives: To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.

Equine blood flow restriction training: Safety validation.

Background: Blood flow restriction (BFR) has become a key rehabilitative tool for human orthopaedic conditions. With modernised technology and evolution of clinical application, patient-specific delivery of occlusion percentages is now considered the standard of care in human patients due to improved therapeutic outcomes and minimised safety risks. Safety validation and limb occlusion pressure (LOP) data for horses, however, are lacking.

TLR-activated mesenchymal stromal cell therapy and antibiotics to treat multi-drug resistant septic arthritis in an equine model.

Background: Rapid development of antibiotic resistance necessitates advancement of novel therapeutic strategies to treat infection. Mesenchymal stromal cells (MSC) possess antimicrobial and immunomodulatory properties, mediated through antimicrobial peptide secretion and recruitment of innate immune cells including neutrophils and monocytes. TLR-3 activation of human, canine and equine MSC has been shown to enhance bacterial killing and clearance , in rodent biofilm infection models and dogs with spontaneous multi-drug-resistant infections.

Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019).

Background: The frequency of surgical site infection (SSI) following orthopaedic implant placement in horses has been reported but not compared with respect to specific antibiotic protocols administered.

Objectives: To determine factors associated with SSI in horses undergoing proximal interphalangeal joint (PIPJ) arthrodesis including perioperative antibiotic protocols.

Methods: Records were evaluated (2010-2019), and horses undergoing PIPJ arthrodesis were identified.

Liposomal bupivacaine provides longer duration analgesia than bupivacaine hydrochloride in an adjustable sole-pressure model of equine lameness.

Objective: To compare the efficacy and duration of action for perineural analgesia with liposomal bupivacaine (LB) versus bupivacaine hydrochloride (BHCl) in a sole-pressure induced model of forelimb lameness in horses.

Animals: 6 healthy adult research horses.

Procedures: In 1 randomly assigned forelimb, grade 3/5 lameness was induced by use of a sole-pressure lameness model.

Raptor Sedation and Anesthesia.

Sedation and/or anesthesia is routinely and successfully used in raptors for a wide variety of procedures from the routine such as physical examination, radiographs, or venipuncture, to the more complex, such as orthopedic surgeries. Understanding the anatomy and physiology of raptor patients who present for care, and being fully prepared before the start of any procedure, can increase the success of anesthetic procedures. Recent advances in raptor sedation and anesthesia continue to improve the health and welfare of these avian patients.

Comparison of equine synovial sepsis rate following intrasynovial injection in ambulatory versus hospital settings.

Background: Frequency of synovial sepsis in horses following intrasynovial injection has been reported, but not compared with respect to the environment in which the injection was performed.

Objectives: To describe occurrence of synovial sepsis following intrasynovial injections performed in ambulatory vs hospital settings.

Study Design: Retrospective cohort study.

Evaluation of Intra-Articular Amikacin Administration in an Equine Non-inflammatory Joint Model to Identify Effective Bactericidal Concentrations While Minimizing Cytotoxicity.

Septic arthritis causes significant morbidity and mortality in veterinary and human clinical practice and is increasingly complicated by multidrug-resistant infections. Intra-articular (IA) antibiotic administration achieves high local drug concentrations but is considered off-label usage, and appropriate doses have not been defined. Using an equine joint model, we investigated the effects of amikacin injected at three different doses (500, 125, and 31.

Impact of Three Different Serum Sources on Functional Properties of Equine Mesenchymal Stromal Cells.

Culture and expansion of equine mesenchymal stromal cells (MSCs) are routinely performed using fetal bovine serum (FBS) as a source of growth factors, nutrients, and extracellular matrix proteins. However, the desire to minimize introduction of xenogeneic bovine proteins or pathogens and to standardize cellular products intended for clinical application has driven evaluation of alternatives to FBS. Replacement of FBS in culture for several days before administration has been proposed to reduce antigenicity and potentially prolong survival after injection.

Toll-like receptor activation of equine mesenchymal stromal cells to enhance antibacterial activity and immunomodulatory cytokine secretion.

Objective: To evaluate effects of Toll-like and nucleotide-binding oligomerization domain (NOD)-like receptor (TLR, NLR) ligand stimulation of equine mesenchymal stromal cells (MSCs) on antibacterial and immunomodulatory properties in vitro.

Study Design: Controlled laboratory study.

Sample Population: Equine bone-marrow-derived MSCs (three horses).

Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy.

Background: Prophylactic perioperative antimicrobial protocols in equine synovial endoscopy have been described but not compared with respect to post-operative outcomes and complications. Increasing antimicrobial resistance in equine practice and interest in promoting judicious use of antimicrobials has prompted reevaluation of drug selection and dosing strategies.

Objectives: To determine the frequency of and compare post-operative complications following elective synovial endoscopy between horses receiving different perioperative antimicrobial protocols.

Evaluation of the Effect of Cannabidiol on Naturally Occurring Osteoarthritis-Associated Pain: A Pilot Study in Dogs.

The objective of this study was to provide preliminary data describing the safety and effect of cannabidiol (CBD) for symptom relief of canine osteoarthritis-associated pain in a clinical setting using objective outcome measures. Twenty-three client-owned dogs with naturally occurring osteoarthritis of appendicular joints completed this prospective, double-blinded, crossover, placebo-controlled study. Baseline data were acquired for 4 wk, followed by random allocation to either placebo or CBD treatment for 6 wk, followed by 6 wk with the opposite treatment.

Use of in vitro assays to identify antibiotics that are cytotoxic to normal equine chondrocytes and synovial cells.

Background: Intra-articular (IA) antibiotic usage is prevalent in equine practice. However, recent emergence of antimicrobial resistance prompts re-evaluation of antibiotic selection, particularly when used prophylactically. Furthermore, many commonly used antibiotics exert direct cytotoxicity to equine cells, and appropriate IA doses have not been defined.

Comparison of ultrasound-guided lumbar plexus and sciatic nerve blocks with ropivacaine and sham blocks with saline on perianesthetic analgesia and recovery in dogs undergoing tibial plateau leveling osteotomy surgery.

Objective: To assess the effects of ultrasound-guided lumbar plexus and sciatic nerve blocks on perianesthetic analgesia and recovery quality in dogs undergoing tibial plateau leveling osteotomy (TPLO).

Animals: A group of twenty 20 dogs.

Study Design: Prospective, randomized, blinded, clinical study.

Financial impact of ultrasound-guided lumbar plexus and sciatic nerve blocks with electrostimulation for tibial plateau leveling osteotomy surgery in dogs.

Objective: To determine the anesthesia cost from ultrasound-guided lumbar plexus and sciatic nerve blocks confirmed with electrostimulation for unilateral tibial plateau leveling osteotomy (TPLO) surgery in dogs.

Study Design: Prospective, randomized, blinded clinical trial.

Animals: A group of 20 dogs weighing 33.

Laparoscopic ovariohysterectomy in goats.

OBJECTIVE To describe a minimally invasive 3-portal laparoscopic approach for elective ovariohysterectomy and the outcome of that procedure in a population of goats. DESIGN Descriptive clinical study. ANIMALS 16 healthy client-owned goats.

AAFP Feline Anesthesia Guidelines.

The overarching purpose of the AAFP Anesthesia Guidelines (hereafter referred to as the 'Guidelines') is to make anesthesia and sedation safer for the feline patient. Scope and accessibility: It is noteworthy that these are the first exclusively feline anesthesia guidelines authored by an expert panel, making them particularly useful as an extensively referenced, practical resource for veterinary practice teams. Because much of the key content is presented in tabular or visual format, the Guidelines have a high level of accessibility and convenience that invites regular usage.